Dilemmas And Decision Making In Dementia Care

This book is invaluable to nurses and all health and social care practitioners working with people living with dementia in a variety of contexts. It presents a series of true-to-life case studies tackling the ethical and practical dilemmas of dementia care and how to use theoretical approaches to come to potential solutions. The reader is encouraged to explore evidence-based approaches to practice, based on the professional reasoning and experience of the practitioner and the emotional psychological and practical needs of the person living with dementia. Key themes running through case studies include: effective communication, person-centred practice, social citizenship, strengths-based approaches and relationship-focused support, as well as organisational culture. Each case study provides readers with opportunities to experience and discuss clinical dilemmas in a safe space with an annotated thinking-aloud framework that allows them to unpack the elements of each situation so as to develop a range of solution-focused perspectives in order to overcome barriers and deliver best practice.

There are always difficult day-to-day decisions to be faced when caring for a person with dementia. This book considers these ethical decisions in the context of relationships, treatment, safety and quality of life, offering practical guidance and advice.

Dementia is a devastating disorder which may dramatically interfere with decision-making abilities. Effort has focused on trying to determine when a person is no longer capable of making particular decisions or is globally incompetent. However, much less focus has been placed on understanding how the capacity to make decisions influences one's view of oneself, one's world and one's treatment by others. This book aims to broaden discussion around this issue by moving beyond a focus on notions of capability and competence to explore the importance of personhood and the underlying complexities of decision-making for those with dementia. Based on papers from the Centre for Research on Personhood in Dementia (CRPD) workshop, experts in dementia care, law, ethics and philosophy discuss the interface between dementia, personhood and decision-making. Drawing on a wide range of interdisciplinary and international perspectives, the book forges new understandings of relationships between everyday, informal decision-making and more formal biomedical or legal processes for assessing competence. This collection of papers provides an in-depth understanding of decision-making in relation to dementia for researchers, healthcare practitioners, service providers, legal professionals and anyone with an interest in personhood in dementia care.

“In this masterful book, Julian Hughes makes a convincing case that many acts in clinical and care practice are ethical matters. Hughes takes us gently through a jungle of philosophical ideas and explores a series of ethical issues in dementia care, such as diagnosis, covert medication and end of life care. His humanity shines through as he favours a values-based approach to care, and concludes by declaring (in the spirit of Tom Kitwood) that the person must be placed first in order to do what is right and good for people living with dementia. A must-have volume for practitioners, social scientists and enlightened general readers.” Tom Dening, Professor of Dementia Research, School of Medicine, University of Nottingham, UK “This book is totally brilliant. The outstanding author Dr. Julian Hughes must now be considered the foremost ethicist of his generation when it comes to caring for individuals with dementia … This is now the book that everyone who cares about dementia and ethics must read, discuss, and implement. It is a huge contribution.” Stephen G. Post PhD, Director, Center for Medical Humanities, Compassionate Care & Bioethics Stony Brook University School of Medicine, USA “This book should be an essential read for all of us who support and navigate the ethical issues relating to people with dementia and their families.” Paul Edwards, Director of Clinical Services, Dementia UK Ethical issues are involved in every decision that is made in connection with someone living with dementia – from decisions about care and treatment to decisions about research and funding. This book encourages the reader to reconsider ethics in dementia care with the use of ‘patterns of practice’, an innovative idea developed by the author. The book highlights the importance of understanding the person’s narrative, of good communication, high quality care, and expert interpretation of the meaning of situations for people living with dementia. This book: • Reviews ethical theories and approaches in connection with dementia care • Considers issues such as such as stigma, quality of life, personhood, and citizenship in relation to dementia • Looks at issues relevant to research ethics • Presents case vignettes to highlight a complete spectrum of ethical issues that arise in dementia care • Is accessibly written for multiple audiences – from people living with dementia to practitioners Dementia and Ethics Reconsidered is a comprehensive account of thought and practice in relation to ethical issues that arise in the context of dementia care, which seeks to show how ethical thinking can be put into practice and prove relevant to day-to-day experience. The Reconsidering Dementia Series is an interdisciplinary series published by Open University Press that covers contemporary issues to challenge and engage readers in thinking deeply about the topic. The dementia fi eld has developed rapidly in its scope and practice over the past ten years and books in this series will unpack not only what this means for the student, academic and practitioner, but also for all those affected by dementia. Series Editors: Dr Keith Oliver and Professor Dawn Brooker MBE. Julian C. Hughes was a consultant in old age psychiatry. Having trained in both philosophy and medicine, he was appointed honorary professor of philosophy of ageing at Newcastle University, UK and subsequently professor of old age psychiatry at the University of Bristol, UK. He was deputy chair of the Nuffield Council on Bioethics, UK.

Although the topic of decision making capacity and older persons has been discussed in the literature, there still is much to be learned about it theoretically and practically. Experts continue to disagree about which standards are important for assessing decision making capacity. Questions such as: ìWhen should a capacity assessment be done on an older person and by whom?î are covered by the editors. Topics included in this volume are the application of an original framework for ethical decision making in long term care; an elder's capacity to decide to remain living alone in the community; the quest for helpful standardized instruments for evaluating decision making capacity; and end-of-life liability issues.

The text focuses on projects which have taken different approaches to working with people with dementia in research, including examining the process of interviewing people with dementia whose first language is not English and encouraging people with dementia to participate in the research analysis.

Dementia is one of the greatest challenges facing seniors and their caregivers around the globe. Developed by experts in both research and practice, this guide for mental health clinicians explores the experience of caregiving in dementia, discussing the latest research developments and sharing clinical pearls of wisdom that can easily be translated to daily practice. The contributors explore the history of caregiving and then examine the current demographics of caregivers for persons with dementia. They discuss who provides care, the settings in which it is delivered, and the rewards and burdens of caregiving. They place special emphasis on understanding the psychological needs of both the person with dementia and the caregiver, as well as interpersonal bonds, spiritual dimensions, and reactions to grief and loss. Using a multidisciplinary approach to treatment for caregivers, this book addresses the role of pharmacotherapy, individual and family interventions, and social supports. Finally, the authors reflect on societal issues such as health care policies, ethnic elders, and ethics. This volume offers health professionals insights into the daily lives of caregivers, along with tools to provide their patients with the support they need.

This book outlines some of the key issues in risk perception, assessment and management in dementia care in a way that is both practical and accessible to a wide range of practitioners. It develops an approach to risk that promotes choice for people with dementia whilst also acknowledging the complex challenges care providers face.